目的 分析南京医科大学附属儿童医院儿外科重症监护病房（SICU）病原菌分布及耐药率，为临床合理选用抗菌药物提供依据。方法 对2017年1月—2021年12月南京市儿童医院SICU患儿送检各类标本所分离的病原菌及其耐药状况进行回顾性分析。结果 11 939例标本共分离出病原菌1 823株，分离率为15.27%。主要分离的革兰阳性菌有金黄色葡萄球菌、凝固酶阴性葡萄球菌；革兰阴性菌有肺炎克雷伯菌、鲍曼不动杆菌、大肠埃希菌、铜绿假单胞菌。金黄色葡萄球菌与凝固酶阴性葡萄球菌的甲氧西林耐药率分别为42.46%、71.68%，未发现耐万古霉素菌株。革兰阴性菌中，有71株肺炎克雷伯菌碳青霉烯耐药菌株，耐药率22.40%。结论 SICU科室应根据患儿自身实际情况合理用药、严格遵循无菌操作规范，监测病原菌分布及耐药状况对抗菌药物的合理选用有重要意义。

Objective The distribution and drug resistance rate of pathogenic bacteria in SICU of Children's Hospital of Nanjing Medical University were analyzed to provide basis for rational selection of antibacterial drugs in clinic. Methods Pathogens isolated from SICU children samples collected from Children's Hospital of Nanjing Medical University from January 2017 to December 2021, and their drug resistance were analyzed retrospectively. Results A total of 1 823 strains were isolated from 11 939 samples, with a separation rate of 15.27%. The main gram-positive bacteria were Staphylococcus aureus and coagulase negative staphylococcus. Gram-negative bacteria were Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, and Pseudomonas aeruginosa. Methicillin resistance rates of Staphylococcus aureus and coagulase negative staphylococcus were 42.46% and 71.68%, respectively, and no vancomycin-resistant strain was found. Among gram-negative bacteria, 71 strains of Klebsiella pneumoniae had carbapenem-resistant rate (22.40%). Conclusion s SICU department should use drugs rationally according to the actual situation of children, strictly follow the aseptic operation specifications, monitoring the distribution of pathogenic bacteria and drug resistance status is of great significance for the rational selection of antibacterial drugs.

R978.1

南京医科大学科技发展基金项目(NMUB2019209)